Wednesday, January 16, 2008

The Genain quadruplets

The Genain quadruplets are a "beautiful" experiment of nature that can teach us a lot about genetic and environmental factors. All four girls share exactly the same genes, and lived in the same family environment. Unfortunately for them but fortunately for science, they share exactly the same genetic predisposition to schizophrenia. In exchange for free treatment, the quadruplets were and still are monitored; they are now about 50 years old. Interestingly, the expression of schizophrenia was very different between the quadruplets: Myra after an initial episode was never hospitalized and is married, Nora was hospitalized repeatedly but had marginal adjustment while outside the hospital, Iris experienced more-chronic hospitalization and her symptoms range from severe catatonic withdrawal to times of marginal adjustment when she was able to leave hospital, and Hester further deteriorated and remains hospitalized! Check out this review: here.

The case study shows that the same genes for schizophrenia (and many other brain disorders like stuttering) can lead to very diverse outcomes, though all quadruplets did develop schizophrenia. The family environment including parenting skills (nurture) were the same for all four, though parents might have treated them differently. However, a difference in treatment is mostly due to the kids being different. So the parents react to the difference of the child.

So why do the Genain quadruplets develop so differently? The answer lies most likely in environmental stressors unique to a child. I would split it in pre-natal and post-natal factors. Pre-natal factors include the position of the child in the womb in relationship to the others, differences in weight due to differences in nutritional supplies, injury, and so on. And post-natal factors include illness, injury, unique random events like a traumatic experience, reactions of parents to behavior proper to one child and so on.

17 comments:

This is an interesting site with lots of good info. Just a comment about the Genain quadruplets - you say they are about 50 yrs old now but they were born April 14, 1930 - making them 78 yrs old this year. A fascinating follow-up study was done in 2000 - all but the youngest (Hester) was given a lot of tests; Hester's dementia was too strong for her to understand anything asked of her. The study is found at Also, you state that they weren't treated differently by their parents, but what I've read indicated that Myra, the oldest and most mentally stable, was treated much better than her sisters. And the two youngest underwent female circumcision at age 11 because their mother hated them masturbating...it sounds as if all four girls underwent some pretty awful parenting....it's a pretty fascinating story -- it's great that you include it on your very interesting blog!

the follow- up study can be found at: schizophreniabulletin.oxfordjournals.org

You also conveniently fail to comment on the fact that the father sexually abused Hester and Iris. He was mentally unstable and the mother was a schizophrenic herself. These quadruplets developed schizophrenia not as a result of genes, but as a result of abuse and harsh treatment by mentally unstable parents.

While I appreciate that you are looking at the scientific intrigue of this case, I am somewhat irritated that you have alot of the information wrong. Iris and Hester are no longer living ( having died long before your article was written) and Myra was divorced many years ago. I think what I am most bothered by is the picture you have posted is definitely not the sisters in question. When they were born in 1930, there was only black and white photography and I just know for a fact that this is not the sisters. I think out of respect to the sisters and to whoever these quads are , you should remove the picture associated with your article.

The supposition of a genetic cause for schizophrenic behaviours that the (genetic theory biased) psychiatry industry assumes has credited this study as monumental for their theory. One question: How would you respond if your father was an alcoholic, paranoid, notorious for affairs on his wife, physcially abusive to wife and kids, restricted kids to home, threatened to kill his wife, played sex games with kids, genital mutilating kids, bit his wife during sex, angry, hateful, mean? How about if your mother was despondent and suicidal and also told her girls to forget about it when they were sexually assaulted? THis info is in the book.Back to my question. When someone tries to control you or power trips you in your life, how do you respond? OK, multiply that by how ever much you think these girls endured and think about how your behaviours would be less than nromal to the outside world.THere is not and never has been proof of any pathology for any mental illness. We dont need drugs, we need caring and love.

I love how all these amatures are diagnosing and offering their "expert" opinions on Schizophrenia. What qualifies you? Well, you've read web sites, so you must know what you're talking about, right?

Correlations don't prove causation, kids. Many people with mental illness are treated like shit, but that doesn't mean the abuse CAUSED their illness. Being mentally ill makes you a TARGET of abuse, especially if your parents are also mentally ill (and are the abusers).

Recognition that Schizophrenia has a biological etiology has been around since Kraepelin, Eugen Bleuler, and others from the 18th century. About 30 years ago, scientists were first able to show scientific evidence of this connection. All you have to do is look at the family, twin, and adoption studies to see that MZ twins have a 48% concordance (compared to 1% in the general population). This number doesn't change when the twins are raised in separate families, showing that their GENES, not their upbringing is responsible for the illness.

People with parents who have Schizophrenia have a 13 times higher risk of being diagnosed compared to the general population, and siblings have a 9 times higher risk; again, this holds true when the children are raised in adoptive families.

Do those of you who follow a more Freudian model of "acquired" Schizophrenia (e.g., the schizophrenogenic mother?) have such compelling evidence? I doubt it.

Schizophrenia is not something you develop because of anything other than genetics--it's not the same as PTSD or anything like that. If you haven't got the chemical imbalances, no external force will give you them, just as you can't actually ever get RID of them (just try to balance things out as best you can with medication). While their childhood undoubtedly did nothing good for any of their conditions, it was not the cause.

Like the anonymous poster above pointed out, in studies it has been proven that if your identical twin has schizophrenia, there is a 48% chance that you will have it as well. That does not mean that schizophrenia is purely genetic. What it means is that schizophrenia is about 50% genetic and 50% environmental. So while you MUST have the genetic predisposition to develop schizophrenia, you also MUST have a stressful environment or traumatic experience to trigger the disease.

Just a note that while yes the disease in genetic, I don't think anyone is saying the environment caused it but that the environment contributed to the outcome of it. If you read the extensive case study done on the Genain quadruplets, its stating that do to the way they grew up and were treated in different ways, was the reason they functioned differently in life. Some better then others. They all would of ended up with the disease but may have been able to manage it better had they had better upbringing with parents who were not so dysfunctional themselves.

We have no reason to be pushed into a "Freudian model" in order to reject the conclusions of the twins studies. Even if the correlation in separately adopted twins was 100%, what would it prove? I would have no problems admitting that perfect twins have similar, say, swimming abilities. I would never dare to piggyback that swimming abilities constitute a genetic condition, caused by a well defined but yet unknown number of gene mutations. And yet, that is exactly what is being done. Latest GWAS effort in this direction gives more than 100 genetic loci responsible for not more than 4% of the incidence of schizophrenia. That's inconclusive to be polite. It's science that is inconclusive, and hence genetic etiology of schizophrenia is unfounded in science.

Where have I mentionned Freud in this argument? Nowhere.

Sorry buddy, you lose. Get to know your science before trying to explain it.